Heart 2001;85:385-389 ( April )

Cardiovascular medicine

Psychological characteristics and fatal ischaemic heart disease A Haines^a, J Cooper^b, T W Meade^b

^a Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, UK, ^b MRC Epidemiology and Medical Care Unit, St Bartholomew's and the Royal London School of Medicine and Dentistry, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK

Correspondence to: Dr Haines, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK andy.haines{at}lshtm.ac.uk

Accepted 21 November 2000

OBJECTIVETo determine the relation between psychological characteristics and subsequent fatal ischaemic heart disease (IHD) events.
DESIGNProspective study of participants in the Northwick Park heart study (NPHS) recruited between 1972 and 1978 and followed up for fatal events until 1997.
SETTINGThree occupational groups in north west London.
SUBJECTS1408 white men without a history of myocardial infarction aged 40-64 years at entry who completed a Crown-Crisp experiential index form (CCEI).
MAIN OUTCOME MEASUREFatal IHD during follow up.
RESULTSA one point increase in the score on the obsessionality/obsessional neurosis subscale was associated with a relative risk of fatal IHD of 1.08 (95% confidence interval (CI) 1.02 to 1.15). For the functional somatic complaint subscale the relative risk was also 1.08 (95% CI 1.02 to 1.15). In the case of the total score the relative risk of fatal IHD was 1.28 (95% CI 1.09 to 1.50) for a 10 point increase. The associations were independent of age, social class, and known cardiovascular risk factors. In the case of phobic anxiety, which had previously been found to be associated with fatal IHD in NPHS, the association was evident in the first 10 years of follow up but overall the relative risk was only 1.07 (95% CI 0.99 to 1.15) for a one point increase in the score.
CONCLUSIONScores on two of the subscales of the CCEI and the total score are significantly associated with fatal IHD on long term follow up independently of other known risk factors.


Keywords: cohort study; ischaemic heart disease; psychological factors

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© 2001 by Heart
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Psychological characteristics and heart disease

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